Immune profiles of allergic asthma patients treated with anti-IgE.
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Upchurch, Katherine C., 1987-
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Asthma is a chronic inflammatory disease of the airways characterized by bronchial hyper-reactivity, mucus overproduction and airway remodeling and narrowing. Of the various phenotypes of asthma, by far the most common is allergic asthma, in which the airway inflammation is triggered by allergen exposure in sensitized individuals. The diagnosis of allergic asthma is usually done through an allergen prick test; high allergen reactivity is correlated with allergy and these patients should also contain allergen-specific IgE antibodies (abs). One of the more effective medications for moderate-to-severe, uncontrollable allergic asthma is omalizumab, an anti-IgE ab that targets free IgE, thus preventing the continuation of IgE-dependent allergic responses. However, the mechanisms behind how anti-IgE treatment influences the pathophysiologic responses remain to be fully revealed. Additionally, only a 21-64% response rate is seen after 16 weeks, despite the underlying allergy pathogenesis. Thus, in order to better understand the role of IgE in the pathogenesis of human allergic asthma and to identify potential biomarkers for response to anti-IgE therapy, we studied the mechanisms of action of anti-IgE abs in allergic asthma patients through the comparison of immune cell composition and activation status and whole blood transcriptional profiling. By acquiring patient samples before the start of anti-IgE treatment, we were also able to compare healthy donors with allergic asthma patients to gleam additional insights into allergic asthma. This study offers a unique global examination on the impacts of anti-IgE on the immune response, as observed in peripheral blood and also gains a further step towards the development of a biomarker for response to anti-IgE treatment.